Individual provider Active NPI

Kelly L Hogen, PTA

  • Physical Therapy Assistant
  • Osceola, WI
National Provider Identifier
1437327392
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
4827-26 Issued in WI
Practice address
2600 65TH Avenue
Osceola, WI 54020-4370
Phone
(715) 294-2111
Fax
(715) 294-5758
NPI assigned
Feb 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 570-019 WI
Physical Therapy Assistant 225200000X 4827-26 WI Primary

Addresses

Primary practice location

2600 65TH Avenue
Osceola, WI 54020-4370

Mailing address

PO Box 218
Osceola, WI 54020-0218
Phone (715) 294-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4827-26WIMDOrthopedic Physical Therapist
570-019WIMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1437327392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540200218",
            "telephone_number": "715-294-2111",
            "fax_number": "715-294-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 65TH AVENUE",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540204370",
            "telephone_number": "715-294-2111",
            "fax_number": "715-294-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGEN",
        "first_name": "KELLY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "570-019",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "4827-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Osceola, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.